Of the thousands of heart attack survivors each year, half remain at risk for sudden death -- despite the best medical care. Yet in this group of patients, preventive therapy with an implantable cardioverter defibrillator reduces the death rate by a remarkable 31 percent, according to research presented at the American College of Cardiologys 2002 meeting in Atlanta, March 17 to 20.
Led by Arthur J. Moss, M.D., professor of Medicine, Division of Cardiology, at the University of Rochester Medical Center, the results of the major, four-year study are also reported in the March 21 issue of The New England Journal of Medicine. The study enrolled 1,232 patients at 76 sites around the world, but the enrollment criteria would apply to 3 to 4 million Americans with heart disease today, and about 400,000 new patients annually, Moss estimates.
The research is the first to show the preventive value of the implantable cardioverter defibrillator (also known as an ICD), a medical device about the size of a pager that is surgically implanted in the chest under local anesthesia. The device detects irregular and potentially fatal heartbeats and shocks the heart back into a normal rhythm. Introduced about 20 years ago, ICDs had been prescribed only for a small group of patients who had survived a cardiac arrest.
But after additional research and improvements to the device itself during the past decade -- with Moss at the forefront -- the most recent trial reaches the broadest group of patients ever and demonstrates the life-saving value of the ICD. This is an important and major contribution to the field, as it sets new standards for therapy to save lives and improve survival, says Moss, principal investigator of the study. Currently there is no other preventive treatment for people at risk of dying suddenly from heart rhythm disorders.
The high-tech device became more widely known after Vice President Dick Cheney had an
Contact: Leslie Orr
University of Rochester Medical Center